Types of fillers and their uses

What is a filler?

A filler, or dermal filler, is a material injected under the skin or into deeper layers to replace lost volume, define features, or improve the appearance of static lines and wrinkles. It differs from Botox, which works by relaxing muscles rather than filling hollows.

The choice of type depends on the area being treated, the depth of injection, the desired result, the nature of the skin and the person’s medical history. So the right question is not “Which type is strongest?” but “Which type suits this area in this case?”

Hyaluronic acid fillers

This is the most widely used type worldwide. Hyaluronic acid is found naturally in the skin; it attracts water and gives tissues fullness and freshness. Products come in different densities: soft, flexible products for the lips and fine lines, and firmer products for the cheeks, chin and jawline.

Key advantages are that results appear almost immediately and that it can be dissolved with a special enzyme if needed, to correct an unwanted result or in case of a complication. Results usually last 6 to 18 months depending on the product, the area and personal factors such as metabolism and how much the area moves.

Collagen-stimulating fillers

Some materials work differently: they provide immediate or gradual volume and stimulate the skin to produce collagen over time. They are usually used in deeper areas rather than the lips.

These materials cannot be dissolved with the enzyme used for hyaluronic acid, so choosing the right case and using precise technique are especially important.

Autologous fat transfer

Instead of a manufactured product, a small amount of the person’s own fat is taken from an area such as the abdomen or thighs, purified and injected into the face to restore volume. Because it is the body’s own tissue, there is no risk of immune rejection.

However, fat transfer is a minor surgical procedure that needs anaesthesia and a longer recovery than routine injections, and part of the transferred fat does not survive, so the result can be less predictable and some people need an additional session. The fat that does survive can be long-lasting.

What about fillers that last for many years?

Some materials are designed to stay in the tissues for many years and cannot be dissolved. Although this may sound like an advantage, facial features change with age, and complications such as lumps or late inflammation are difficult to treat with these materials and may need surgery. Many doctors are therefore very cautious about using them or avoid them.

If you have previously been injected with a material whose type you do not know, it is important to tell the doctor before any new procedure in the same area.

Common injection areas and side-effects

Fillers are used in many areas, and the doctor chooses the material, density and depth suited to each. Most side-effects are minor and temporary, such as swelling, bruising and tenderness at the injection site, and small lumps or infection can occasionally occur. A rare but serious complication is blockage of a blood vessel, an emergency that needs immediate treatment.

• Lips: to add volume, define the borders or improve balance.
• Cheeks and mid-face: to restore lost volume and lift features naturally.
• Under the eyes: in selected cases and with particular care, as the skin is thin and the area sensitive.
• Nose-to-mouth lines and marionette lines around the mouth.
• Chin and jawline: to define features and improve the profile.
• Nose: for minor non-surgical corrections in specific cases, with particular risks that must be discussed.

Who should avoid fillers, and when to contact the doctor

Fillers are usually not advised during pregnancy or breastfeeding, where there is active skin infection such as cold sores or inflamed acne in the area, or in people with a known allergy to the product’s ingredients. People with autoimmune conditions or bleeding disorders, or who take blood thinners, need a specific assessment.

Contact the doctor immediately if, after injection, you notice severe pain, whitening, bluish or mottled skin, or any change in vision. At consultation, ask: What material is proposed and why? Can it be dissolved? How long does it usually last in this area? And what is the plan if the result is not what I expected? Remember that results vary from person to person.